A Case of Inflammatory Pseudotumor of the Liver which Presented Difficulty in Differential Diagnosis Cholangiocellular Carcinoma

Kojun Okamoto, Fuyo Yoshimi, Dai Shida, Daiji Oka¹⁾, Takami Hagihira, Yasukazu Shioyama²⁾, Jiro Shimazaki and Masayuki Itabashi³⁾

Department of Surgery¹⁾, Radiology²⁾, Pathology³⁾, Ibaraki Prefectural Central Hospital and Cancer Center

A71-year-old male was hospitalized for malaise and pyrexia, which were alleviated antibiotics. The patient was referred to us due to a tumorous hepatic lesion about 5 cm long, from hepatic S1 to S4∼8, detected by abdominal computed tomography (CT). CT during arterialportography (CTAP) showed both arterial and portal blood flow in the lesion and CT during arteriography (CTA) showed uneven dark stains in the phase where the arterial blood flow was dominant. Uneven stains were also seen in the anaphase region. Magnetic resonance imaging (MRI) showed the mixed presence of unbalanced iso and low intensities in T1WI and a somewhat high intensity in T2WI, indicating cholangiocellular carcinoma. We excised the enlarged hepatic left lobe and caudate lobe. Postoperative pathological examination showed the lesion to be a nonmalignant solid tumor, leading to a diagnosis of inflammatory pseudotumor evidencing increased growth of fibrous cells and the mixed presence of inflammatory cells. The patient's postoperative couse was favorable, and he was released on postoperative day (POD) 12.

Key words
inflammatory pseudotumor of the liver, hepatectomy

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Kojun Okamoto Department of Surgery, Ibaraki Prefectural Central Hospital and Cancer Center 6528 Koibuchi, Tomobe-cho, West-Ibaraki-gun, Ibaraki, 309-1703 JAPAN

Accepted
September 20, 2000

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